All you need to know about folic acid and folate (a simple guide)
Ever heard of folic acid? Maybe you know it as that nutrient that has to be taken during pregnancy. Folic acid, a type of folate, is so much more and in this article we’re going to provide a simple guide to why folic acid is so important and why you need to make sure you’re getting enough of it. If you already supplement folic read this article as it will help you to understand which forms you should and shouldn’t be taking.
What is folate?
Folate is a nutrient that belongs to the b vitamin family and is critical to a process called methylation. Methylation is connected to most functions! Think about that. One nutrient is critical to a process involved in most functions in the body.
Folate exists in natural and man-made forms.
Folic acid is a man-made, synthetic form of folate. When ingested, it can be converted into folate.
Methylfolate is a naturally occurring form of folate found in foods and also some supplements.
Sometimes the terms folic acid and folate are used interchangeably.
Why do we need folate?
Folate is a nutrient that is required in a very small amounts. It is vital for our body to function normally and for us to sustain a healthy balance throughout our metabolic systems.
Not getting adequate amounts of folate, whether due to diet or a side effect of disease or medication, can lead to folate-deficient conditions. According to BrainMD, here are just a few of the actions of folate:
- maintains healthy levels of red blood cells
- elevates mood
- keeps the brain functioning well
- imparts necessary methyl groups to synthesize, repair and regulate DNA
- regulates neurotransmitters
- develops and enables growth of the fetus in pregnant women
Where is folate found?
Since our bodies are incapable of producing their own folate, it is necessary to obtain it from food, or, if necessary, from supplements. Folate occurs naturally in green leafy vegetables such as spinach and lettuce,lentils, avocados, citrus fruits, carrots, squash, corn, beans, legumes, grains, peas, and nuts.
What is the difference between folate and synthetic folic acid?
Folic acid is commercially available as a dietary supplement in its synthetic form (pteroyl-L-glutamic acid). Once inside the body, folic acid is converted to its active form, the L-methylfolate, with the help of an enzyme called methylenehydrofolatereductase (MTHFR).
Folate refers to the nutrient found in nature and the active form found in humans, otherwise known as methylfolate.
Why methylfolate is the next big thing?
Methylfolate, unlike folic acid, can cross both cell membranes and blood-brain barriers, making it a far more convenient and effective form to utilize. People with specific gene mutations or MTHFR suppression due to a medical condition, as well as those taking certain medications, cannot actively convert folic acid to methylfolate. This can lead to the accumulation of unmetabolized folic acid in the body which has been linked to poor immune activity, prostate cancer, smaller red blood cells, lower cognitive ability, and a variety of other health conditions. Methylfolate serves as a better option in terms of being safe, natural, and available for use directly by the body.
Functions of Folate
Pregnancy
Folic acid has long been taken by pregnant women. However, new research supports the concept that methylfolate could be more effective in all women. In a recent study conducted on 144 women of childbearing age, those who took methylfolate showed higher levels of folate in their red blood cells compared to those who took synthetic folic acid.
Low blood folate is considered one of the leading causes of preterm pregnancies. A study carried out on 34,480 women found that women who took folate supplements for at least a year had significantly decreased chances of preterm birth.
Foetal development
Methylfolate supplementation helps avoid neural tube defect which can affect the brain, spine, and spinal cord of foetuses. Pregnant women with a family history of neural tube defects are advised to take relatively higher doses of folate than other pregnant women. Other developmental issues, such as heart defects and orofacial cleft, have also been linked to folate-deficient pregnancy.
Combating anemia
Anemia is a blood disorder characterized by either low levels of red blood cell concentration, distortion of red blood cell shape, or reduced red blood cell ability to carry oxygen. Haemoglobin levels tend to decrease in pregnant women.
A retrospective study found that 58 pregnant women who took prenatal supplements coupled with methylfolate had higher hemoglobin levels at the time of delivery as compared to 54 women who took regular folic acid.
Managing depression
Methylfolate, being the most active form of folate that can cross the blood-brain barrier, tends to provide the necessary methyl groups for various brain functions, including healthy regulation of mood-inducing hormones such as endorphins and serotonin.
In one study conducted among 123 patients suffering from either clinical depression or schizophrenia, it was found that one-third of them had folate deficiency. These patients were divided into two groups. One group was given methylfolate while the other received a placebo. The patients taking methylfolate improved both clinically and socially. This difference became significant with increased time of supplementation.
In another study, 68 patients who were actively taking antidepressants were also given methylfolate supplements for 12 months. Of the 68 patients, 26 recovered without any relapse, 35 experienced a lessening of severity and frequency of depressive episodes and the remaining seven showed no signs of improvement.
Metabolic recycling of homocysteine
Homocysteine is a byproduct of the folic acid to methylfolate conversion and is evidence of an amino acid called methionine in the body. If the amount of homocysteine builds up in the blood or tissues, it becomes toxic. This condition is called hyperhomocysteinemia and, if left unchecked for a long period of time, can lead to risk of heart disease. However, methylfolate facilitates the metabolic recycling of excess homocysteine to methionine.
Managing schizophrenia
Schizophrenia is a complicated and not yet entirely understood mental illness. However, while studying the relation of folate levels in relevance to the gene mutation, a test was conducted on 140 schizophrenic patients. Those given methylfolate supplements coupled with their medication improved considerably. Another study conducted on 35 schizophrenic patients found that methylfolate supplements improved symptoms and physiological changes in the brain.
Maintaining brain health
Methyl, itself, is an organic functional group essential for numerous metabolic reactions. It comes from methylfolate and is actively involved in all sorts of physical processes from fertilization to the development of vital organs such as heart, brain, and lungs. At a cellular level, methyl is required to synthesize, repair, and regulate DNA..
What is the recommended daily intake of folic acid?
In the UK the Nutrient Reference Value (NRV) for folic acid is suggests that adults receive 200 mcg per day. For pregnant and lactating women, however, a dose of 400 mcg per day is advised.
What can reduce folate concentration levels in the body?
Folic acid is contraindicated with certain medications as well as lifestyle choices such as drinking excessive amounts of alcohol, as the combinations may lead to lower methylfolate levels. Medications that are contraindicated include:
- Alcohol
- Anticonvulsants
- Oral contraceptives
- Antacids
- Some statins
- Metformin
What to consider before choosing to take folate
It is rare to be allergic to either synthetic folic acid or methylfolate, but it is best to be sure, so start by consulting your GP. Also consult your doctor if you experience any of the following conditions:
- Epilepsy or seizures
- Clinical depression or bipolar disorder
- History of vitamin B12 deficiency or pernicious anemia
- Pregnancy or breastfeeding
- Taking oral contraceptives regularly
Are there any side effects of frequently taking folic acid or methylfolate?
Since methylfolate is the purest and most naturally occurring folate variant, it does not have any serious side effects. However, in rare cases, allergic reactions may occur. In you observe rash or experience bloating, stop use immediately, and consult your GP.
What if I miss a dose?
Since it’s a vitamin, it is highly unlikely for anything to happen if you miss a dose. However, take the missed dose as soon as you can. It is advised not to take an extra dose to make up for a previously missed dose.
What if I overdose on folic acid or folate?
Folic acid/folate is a water-soluble compound, which means it does not stay in the body for long periods of time. There are no recorded symptoms of overdose and it is not likely to cause any significant harm.
What are the signs and symptoms of folate deficiency?
Folate deficiency is a prevalent issue. In the US, 30 to 40 percent of women cannot metabolize synthetic folic acid efficiently. A few symptoms of folate deficiency are:
- Lethargy
- Brain fog
- Mood swings
- Pale skin
- Cankers/swollen tongue
- Irritability
- Premature hair graying
- Headaches
- Poor immune function
- Upset bowel movements
Should I take folic acid during pregnancy?
Yes. In fact, it is likely to be more beneficial due to already being present in its active form. One in four people cannot metabolize folic acid efficiently. For a pregnant woman, the dose is likely to be higher than the average dose. We recommend 400 micrograms of methylfolate per day.
Should I take methylfolate during breastfeeding?
Breastfeeding mothers require more energy and vitamins to meet their daily nutritional needs. Folate is excreted in breast milk. Only when the mother has a sufficient amount of folate in her body will it be excreted in the milk to the baby. So yes, it is important to continue to take your daily dose of methylfolate for yourself as well as your baby.
Why is methylfolate better than synthetic folic acid?
Due to the risks associated with taking synthetic folic acid and taking into account that one fourth of the general population fails to metabolize folic acid into its required active form, it safer and more effective to take the natural form.
Why are folic acid supplements marketed more than methylfolate supplements?
The simple answer to that is because methylfolate is a high-end ingredient. It is expensive and thus less commonly available in the market as compared to synthetic folic acid supplements. However, methylated folates remain the best option for your body.
What is the difference between the absorption rates of natural and synthetic forms?
The absorption rate of methyl folate is 100%, while the absorption rate for folic acid is 85%.
How do I take methylfolate supplements?
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Supplement packaging comes with clear instructions. Follow those.
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Use only the dose that your doctor has prescribed in case of pregnancy or when coupled with other health medications.
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Do not chew, break, or crush extended-release tablets. Swallow them whole.
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Never share your supplements, no matter how similar your symptoms may appear to be.
Why should you switch to methylfolate supplements?
When it comes to health, no one should have to compromise on quality. Methylfolate is all-natural and has no side effects. It is only fair to your body that you invest in supplements that promise the best there is and methylfolate is far superior to folic acid.
The Evidence
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Folic Acid Supplementation And Pregnancy: More Than Just Neural Tube Defect Prevention
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Enhancement Og Recovery From Psychiatric Illness By Methylfolate
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Assessing Effects Of L-Methylfolate In Depression Management
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L-Methylfolate: A Promising Therapy for Treatment-Resistant Depression
